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https://www.readbyqxmd.com/read/28649851/avoidance-of-urinary-catheterization-to-minimize-in-hospital-complications-after-transcatheter-aortic-valve-implantation-an-observational-study
#1
Sandra B Lauck, Jae-Yung Kwon, David A Wood, Jennifer Baumbusch, Tone M Norekvål, Nay Htun, Leo Stephenson, John G Webb
BACKGROUND: Contemporary transcatheter aortic valve implantation (TAVI) devices and approach present opportunities to review historical practices initially informed by early treatment development and cardiac surgery. The avoidance of urinary catheterization in the older TAVI population is a strategy to minimize in-hospital complications. The purpose of the study was to explore elimination-related complications following the phased implementation of a default strategy of avoiding urinary catheterization in patients undergoing transfemoral (TF) TAVI...
June 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28645301/the-sternal-management-accelerated-recovery-trial-s-m-a-r-t-standard-restrictive-versus-an-intervention-of-modified-sternal-precautions-following-cardiac-surgery-via-median-sternotomy-study-protocol-for-a-randomised-controlled-trial
#2
Md Ali Katijjahbe, Linda Denehy, Catherine L Granger, Alistair Royse, Colin Royse, Rebecca Bates, Sarah Logie, Sandy Clarke, Doa El-Ansary
BACKGROUND: The routine implementation of sternal precautions to prevent sternal complications that restrict the use of the upper limbs is currently worldwide practice following a median sternotomy. However, evidence is limited and drawn primarily from cadaver studies and orthopaedic research. Sternal precautions may delay recovery, prolong hospital discharge and be overly restrictive. Recent research has shown that upper limb exercise reduces post-operative sternal pain and results in minimal micromotion between the sternal edges as measured by ultrasound...
June 23, 2017: Trials
https://www.readbyqxmd.com/read/28638157/complex-cardiac-surgery-on-patients-with-a-body-weight-of-less-than-5-kg-without-donor-blood-transfusion
#3
Wolfgang Boettcher, Frank Dehmel, Mathias Redlin, Oliver Miera, Michele Musci, Mi-Young Cho, Joachim Photiadis
Performing safe cardiac surgery in neonates or infants whose parents are Jehovah's Witnesses is only possible in a coordinated team approach. An unconditional prerequisite is a cardiopulmonary bypass (CPB) circuit with a very low priming volume to minimize hemodilution. In the past decade, we have developed a functional blood-sparing approach at our institution. The extracorporeal circuit was miniaturized. This had to be recently adapted, faced with a challenge associated with the switch to high-volume crystalloid cardioplegia...
June 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28633259/mycobacterium-chimaera-infection-after-cardiac-surgery-first-canadian-outbreak
#4
Raphael Hamad, Pierre-Emmanuel Noly, Louis P Perrault, Michel Pellerin, Philippe Demers
Recently reported in Europe and United States, disseminated Mycobacterium chimaera infection is a novel clinical entity linked to point contamination of Stockert 3T heater-cooler units used for cardiopulmonary bypass. We present here the first two cases in Canada. Both patients presented with nonspecific extracardiac symptoms 1 year after undergoing minimally invasive mitral surgical repair. Before the right diagnosis was established, the patients were initially treated with prednisone for suspected sarcoidosis...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28629872/sevoflurane-relieves-lung-function-deterioration-after-cardiopulmonary-bypass
#5
Adam L Balogh, Ferenc Peták, Gergely H Fodor, Roberta Sudy, Barna Babik
OBJECTIVE: To investigate sevoflurane's potential to alleviate the detrimental pulmonary changes after cardiopulmonary bypass (CPB). DESIGN: Prospective, randomized clinical investigation. SETTING: University hospital. PARTICIPANTS: One hundred ninety patients undergoing elective cardiac surgery. INTERVENTIONS: Ninety-nine patients under intravenous anesthesia were administered 1 minimal alveolar concentration of sevoflurane for 5 minutes after being weaned from CPB (group SEV); intravenous anesthesia was maintained in the other 91 patients (group CTRL)...
February 24, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28629228/use-of-provider-debriefing-to-improve-fast-track-extubation-rates-following-cardiac-surgery-at-an-academic-medical-center
#6
Jordan E Goldhammer, Jillian M Dashiell, Scott Davis, Marc C Torjman, Hitoshi Hirose
When used in appropriate patient populations, fast-track extubation (FTE) anesthetic techniques and intensive care unit (ICU) protocols safely reduce intubation times, ICU length of stay, and resource utilization. The authors hypothesized that perioperative provider debriefing on success or failure of FTE would improve FTE success. This retrospective observational study included consecutive patients undergoing elective coronary artery bypass graft (CABG), valve, or combined CABG/valve surgery between February 2015 and May 2016 (N = 313)...
June 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28625437/inhalation-versus-intravenous-anaesthesia-for-adults-undergoing-on-pump-or-off-pump-coronary-artery-bypass-grafting-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#7
REVIEW
Regina El Dib, José E Guimarães Pereira, Arnav Agarwal, Huda Gomaa, Ana Patricia Ayala, Andresa Graciutti Botan, Leandro Gobbo Braz, Luciane Dias de Oliveira, Luciane Cruz Lopes, Preethy J Mathew
STUDY OBJECTIVE: To compare the use of inhalation versus intravenous anaesthesia for adults undergoing on-pump or off-pump coronary artery bypass grafting. DESIGN: A systematic review. SETTING: A hospital-affiliated university. MEASUREMENTS: The following databases were searched: the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 10), MEDLINE, EMBASE, and LILACS (from inception to October 2016). We used the GRADE approach to rate overall certainty of the evidence...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28592789/are-sutureless-aortic-valves-suitable-for-severe-high-risk-patients-suffering-from-active-infective-aortic-valve-endocarditis
#8
Alexander Weymann, Johanna Konertz, Michael Laule, Karl Stangl, Pascal M Dohmen
BACKGROUND Sutureless aortic valves were introduced to facilitate minimally invasive aortic valve surgery. Since sutureless aortic valves are a feasible procedure, we evaluated if any benefits could be identified in severe high-risk patients with active infective endocarditis of the aortic valve. MATERIAL AND METHODS Between April 2014 and April 2015, a total of 42 patients received a sutureless Perceval® aortic valve (Sorin Biomedica Cardio Srl, Saluggia, Italy) for different indications. Nine of these patients (median age 71 years, range 47-83 years) suffered from active infective endocarditis, including four patients with prosthetic aortic valve endocarditis...
June 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28589141/postoperative-echocardiographic-reduction-of-right-ventricular-function-is-pericardial-opening-modality-the-main-culprit
#9
Marco Zanobini, Matteo Saccocci, Gloria Tamborini, Fabrizio Veglia, Alessandro Di Minno, Paolo Poggio, Mauro Pepi, Francesco Alamanni, Claudia Loardi
Echocardiographic reduction of RV function, measured using TAPSE, is a well described phenomenon after cardiac surgery. The aim of the present study was to investigate the relation between the modality of pericardial opening (lateral versus anterior) and the postoperative right ventricular systolic function by comparing echocardiographic parameters in patients undergoing minimally invasive or traditional mitral valve repair. 34 patients with severe mitral regurgitation due to mitral valve prolapse underwent traditional (sternotomy) operation (Group A) or minimally invasive surgery with right anterolateral thoracotomy (Group B)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28587598/methodologic-considerations-in-the-design-and-analysis-of-nested-case-control-studies-association-between-cytokines-and-postoperative-delirium
#10
Long H Ngo, Sharon K Inouye, Richard N Jones, Thomas G Travison, Towia A Libermann, Simon T Dillon, George A Kuchel, Sarinnapha M Vasunilashorn, David C Alsop, Edward R Marcantonio
BACKGROUND: The nested case-control study (NCC) design within a prospective cohort study is used when outcome data are available for all subjects, but the exposure of interest has not been collected, and is difficult or prohibitively expensive to obtain for all subjects. A NCC analysis with good matching procedures yields estimates that are as efficient and unbiased as estimates from the full cohort study. We present methodological considerations in a matched NCC design and analysis, which include the choice of match algorithms, analysis methods to evaluate the association of exposures of interest with outcomes, and consideration of overmatching...
June 6, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28582512/minimally-invasive-mitral-valve-repair-in-osteogenesis-imperfecta
#11
Isabella Tagliasacchi, Luigi Martinelli, Leopoldo Bardaro, Sergio Chierchia
Osteogenesis imperfecta is a disorder of the connective tissue that affects several structures including heart valves. However, cardiac surgery is associated with high mortality and morbidity rates. In a 48-year-old man with osteogenesis imperfecta and mitral valve prolapse, we performed the first successful mitral valve repair by right anterior mini-thoracotomy. At the 1-year follow-up, he was asymptomatic and echocardiography confirmed the initial success.
June 5, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28582328/euroscore-performance-in-minimally-invasive-cardiac-surgery-discrimination-ability-and-external-calibration
#12
Rafik Margaryan, Marco Moscarelli, Tommaso Gasbarri, Giacomo Bianchi, Enkel Kallushi, Alfredo Giuseppe Cerillo, Pierandrea Farneti, Marco Solinas
OBJECTIVE: Prediction of operative risk in adults undergoing cardiac surgery remains a challenge. The European System for Cardiac Operative Risk Evaluation (EuroSCORE) is one of the most commonly used in clinical settings. Recently, the new EuroSCORE II was published attempting to improve the accuracy of risk prediction. We sought to assess the predictive value of EuroSCORE or EuroSCORE II in selected field of minimally invasive cardiac surgery. METHODS: Patients who underwent cardiac surgery operation with minimally invasive approach from 2007 to 2013 identified from prospective cardiac surgical database...
June 2, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28581447/time-window-is-important-for-adenosine-preventing-cold-induced-injury-to-the-endothelium
#13
Yan Li, Xiao-Xia Hu, Li Fu, Jing Chen, Li-He Lu, Xiang Liu, Zhe Xu, Li Zhou, Zhi-Ping Wang, Xi Zhang, Zhi-Jun Ou, Jing-Song Ou
Cold cardioplegia is used to induce heart arrest during cardiac surgery. However, endothelial function may be compromised after this procedure. Accordingly, interventions such as adenosine, that mimic the effects of preconditioning, may minimize endothelial injury. Herein, we investigated whether adenosine prevents cold-induced injury to the endothelium. Cultured human cardiac microvascular endothelial cells were treated with adenosine for different durations. Phosphorylation and expression of endothelial nitric oxide synthase (eNOS), p38MAPK, ERK1/2, and p70S6K6 were measured along with nitric oxide (NO) production using diaminofluorescein-2 diacetate (DAF-2DA) probe...
June 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28581209/the-effect-of-continuous-exenatide-infusion-on-cardiac-function-and-perioperative-glucose-control-in-cardiac-surgery-patients-a-single-blind-randomized-controlled-trial
#14
Michal Lipš, Miloš Mráz, Jana Kloučková, Petr Kopecký, Miloš Dobiáš, Jarmila Křížová, Jaroslav Lindner, Michaela Diamant, Martin Haluzík
To intensify perioperative glucose control while minimizing the risk of hypoglycemia and to evaluate the suggested cardioprotective effects of GLP-1-based treatments we performed a randomized controlled trial with the GLP-1 receptor agonist exenatide as add-on to standard perioperative insulin therapy in subjects undergoing elective cardiac surgery. 38 subjects with decreased left ventricular systolic function (ejection fraction ≤50%) scheduled for elective CABG (coronary artery by-pass grafting) were randomized to receive either exenatide or placebo in a continuous 72-hour i...
June 5, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28580776/do-we-have-enough-evidence-for-minimally-invasive-cardiac-surgery-a-critical-review-of-scientific-and-non-scientific-information
#15
REVIEW
Torsten Doenst, Joseph Lamelas
Reducing surgical trauma by minimizing skin incisions has transformed abdominal surgery resulting in significant improvements in outcome. In cardiac surgery, such efforts have also been made, but similar benefits could not be demonstrated. In addition, any potential benefit comes at the cost of increased cardiopulmonary bypass and clamp times, leading to questions regarding the safety of minimally invasive cardiac surgery (MICS). Nevertheless, outcomes have been equivalent to matched sternotomy cases and there is no doubt that the number of patients undergoing minimally-invasive mitral or aortic procedures is slowly increasing...
August 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28578622/modular-minimal-invasive-extracorporeal-circuits-another-step-toward-universal-applicability
#16
Aschraf El-Essawi, Mohammed Morjan, Ingo Breitenbach, Ahmed Bechri, Rene Brouwer, Wolfgang Harringer
INTRODUCTION: Safety concerns have been one of the main reasons opposing a wider acceptance of minimal invasive extracorporeal circuits (MiECC). Following an extensive experience and a multitude of modifications, we have set out to employ a modular MiECC as a universal extracorporeal circuit. METHODS: A total of 129 cardiac surgical procedures were performed by a single surgeon in 2013. Excluding procedures done under circulatory arrest or with the potential need of such, the MiECC was utilized in almost 90% of surgeries...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28577850/chronic-myocardial-ischemia-leads-to-loss-of-maximal-oxygen-consumption-and-complex-i-dysfunction
#17
David A Schipper, Ryan Palsma, Katherine M Marsh, Connor O'Hare, Destiny S Dicken, Scott Lick, Toshinobu Kazui, Kitsie Johnson, Ryszard T Smolenski, Dirk J Duncker, Zain Khalpey
BACKGROUND: Cardiomyocytes rely heavily on mitochondrial energy production through oxidative phosphorylation. Chronic myocardial ischemia may cause mitochondrial dysfunction and affect ATP formation. Metabolic changes due to ischemia alters cardiac bioenergetics and hence myocardial function and overall bioenergetic state. Here, we evaluate differences in functional status of respiratory complexes in mitochondrial isolates extracted from left atrial appendage tissue (LAA) from patients undergoing cardiac surgery, with and without chronic ischemia...
June 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28577472/general-movement-trajectories-and-neurodevelopment-at-3months-of-age-following-neonatal-surgery
#18
Cathryn Crowle, Karen Walker, Claire Galea, Iona Novak, Nadia Badawi
BACKGROUND: Neonates who undergo major surgery are at risk of neurodevelopmental disability. The General Movements Assessment (GMA) is a valid and reliable method to predict neurodevelopment, however, there are minimal data on the applicability among infants post-surgery. AIM: To describe GMs trajectories following neonatal surgery. STUDY DESIGN: Prospective cohort study. SUBJECTS: 217 infants following major cardiac and non-cardiac neonatal surgery...
May 31, 2017: Early Human Development
https://www.readbyqxmd.com/read/28553871/in-hospital-and-long-term-outcomes-of-coronary-artery-bypass-graft-surgery-in-patients-%C3%A2-45-years-of-age-and-older-from-the-krok-registry
#19
Przemysław Trzeciak, Wojtek Karolak, Mariusz Gąsior, Marian Zembala
BACKGROUND: There is a paucity of data concerning the clinical characteristics, management and outcomes of coronary artery bypass graft surgery (CABG) in patients ≤45 years old. AIM: We aimed to compare the clinical characteristics, in-hospital and long-term outcomes of patients ≤45 years and >45 years who underwent isolated CABG. METHODS: We identified consecutive patients who had isolated CABG in Department of Cardiac Surgery and Transplantology in Silesian Center for Heart Diseases in Zabrze between January 2006 and December 2011 and were enrolled in the Polish National Registry of Cardiac Surgery Procedures (KROK registry)...
May 29, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28549029/a-contemporary-approach-to-reoperative-aortic-valve-surgery-when-is-less-more
#20
Deane E Smith, Michael S Koeckert, Patrick F Vining, Elias A Zias, Eugene A Grossi, Aubrey C Galloway
OBJECTIVE: Although the benefits of minimally invasive valvular surgery are well established, the applicability of extending these techniques to reoperative aortic valve surgery is unknown. We evaluated our experience with a minimally invasive approach to this patient population. METHODS: From January 2010 to September 2015, 21 patients underwent reoperative isolated aortic valve replacement via a minimally invasive approach by a single surgeon. All patients had preoperative evaluation with computerized tomography and coronary catheterization...
May 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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